Provider Demographics
NPI:1700121035
Name:PISANI, JOSEPH (BA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:PISANI
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38791 US HIGHWAY 19 N
Mailing Address - Street 2:602
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-9409
Mailing Address - Country:US
Mailing Address - Phone:727-421-8211
Mailing Address - Fax:
Practice Address - Street 1:38791 US HIGHWAY 19 N
Practice Address - Street 2:602
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-9409
Practice Address - Country:US
Practice Address - Phone:727-421-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No372500000XNursing Service Related ProvidersChore Provider
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel